Athlete weekly surveillance report

Improving the Understanding of Traumatic Brain Injury through Policy and Program Evaluation

Documents and Forms

Document Name Document Type
Athlete weekly surveillance report Form
Athlete weekly surveillance report AttachF-Weekly Ath IVR_rev0323.doc Form
AttachR_Weekly Report Follow Up email phone script.docx Weekly report follow-up IC Document

Information Collection (IC) Details

IC Title:	Athlete weekly surveillance report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Athlete weekly surveillance report	AttachF-Weekly Ath IVR_rev0323.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title: Records of subjects in health promotion and educational studies	FR Citation: 51 FR 42484

Number of Respondents: 1,518	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	15,180	15,180
Annual IC Time Burden (Hours)	759	759
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Weekly report follow-up	AttachR_Weekly Report Follow Up email phone script.docx	03/30/2015

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.